Individual provider Active NPI

Holly A T Schroeder, MD

  • Pediatrics Physician
  • Keene, NH
National Provider Identifier
1396182440
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22259 Issued in NH
Practice address
590 Court St
Keene, NH 03431
Phone
(603) 354-5400
NPI assigned
May 30, 2013
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60762190 WA
Pediatrics Physician 208000000X 22259 NH Primary
Pediatric Adolescent Medicine Physician 2080A0000X 60762190 WA

Addresses

Primary practice location

590 Court St
Keene, NH 03431

Mailing address

590 Court St
Keene, NH 03431
Phone (603) 354-5400

Other identifiers 1

IdentifierTypeStateIssuer
MD15303OtherRILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220128000065 NH Practitioner - Pediatric Medicine 9032338926 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60762190WAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince May 23, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 18, 2022 Accepting new patients
Cheshire Medical Center CurrentSince Jan 18, 2022 Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Jan 18, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince May 23, 2022 Accepting new patients

Locations

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: hschroeder462394@direct.dartmouth-hitchcock.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1396182440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-354-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "HOLLY",
        "middle_name": "A T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60762190",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "22259",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "60762190",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD15303",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.